Provider Demographics
NPI:1912981416
Name:KLEINMAN, MARTIN S (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:S
Last Name:KLEINMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-1613
Mailing Address - Country:US
Mailing Address - Phone:585-244-7744
Mailing Address - Fax:
Practice Address - Street 1:919 WESTFALL RD
Practice Address - Street 2:BLDG C-100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2638
Practice Address - Country:US
Practice Address - Phone:585-271-2800
Practice Address - Fax:585-271-0375
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092650207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000913706001OtherHEALTH NOW
100016378OtherMEDICARE RAILROAD
2210649OtherAETNA
7702334OtherMVP
7810021OtherAETNA
10211BTOtherPREFERRED CARE
P0100092650OtherEXCELLUS
P100092650OtherEXCELLUS
1287OtherEXCELLUS
20G371OtherEMPIRE
NY00459485Medicaid
7810021OtherAETNA
20G371OtherEMPIRE